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Soft Tissue Tumors
Hemosiderotic fibrohistiocytic lipomatous lesion
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Reviewer: David Lucas, M.D., University of Michigan Health Systems (January 2009)
Revised: 26 June 2009, last major update June 2009
Definition
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● Superficial benign fatty lesion, usually of foot/ankle, with CD34+ spindle cells and abundant hemosiderin
● Not a WHO diagnosis
Epidemiology
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● Rare (10 per 6000 lipomas), usually women, mean age 51 years (range, 42-63 years)
● Usually ankle region
● Associated with trauma (70%); may be reactive (Mod Path 2000;13:1192)
● Associated with venous stasis (Virchows Arch 2005;447:103)
● May be related to early pleomorphic hyalinizing angiectatic tumor (Pathol Int 2006;56:283, AJSP 2004;28:1417)
Treatment and prognosis
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● Radical surgical excision and follow up
● May recur locally
● No metastases or deaths
Gross description
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● Mean 8 cm (range, 2-17 cm)
Micro description
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● Unencapsulated circumscribed superficial fatty lesion with CD34+ spindle cells and abundant hemosiderin
● Spindle cells have vesicular nuclei and indistinct nucleoli with occasional hyperchromatism
● Inflammatory background
● No/minimal atypia
Micro images
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Circumscribed fatty component Pigment mixed with histiocytic,
and spindle cells fibroblastic and myofibroblastic spindled cells
Spindle cells are plump, mildly Pigment is iron, confirmed
pleomorphic and run along fibrous with iron stain
septa and around individual adipocytes
Various images
CD68+ and lysozyme+ Calponin+ and CD34+
Positive stains
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● CD34, vimentin, calponin
Negative stains
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● S100, desmin
Additional references
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End of Soft Tissue Tumors > Hemosiderotic fibrohistiocytic lipomatous lesion
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